Congenital bilateral choanal atresia: a novel stenting technique in neonates

A new stenting technique is described which may reduce the incidence of restenosis in choanal atresia after decannulation. Eight neonatal cases with bilateral congenital bony choanal atresia were treated by endonasal perforation. A modified stenting technique utilising endotracheal tubes provided good fixation and stability. This aided epithelialisation of the newly formed tract. Furthermore the stents projected beyond the atretic plate preventing granulation tissue growth over the choanae, thus preventing restenosis. The stents were left in situ for six to eight weeks. The patients were followed up for periods ranging from eighteen months to eleven years. Seven did not require further treatment, and one required unilateral dilatation. Meticulous care in fixing and securing a well designed stent for an appropriate time may be a factor in reducing the incidence of restenosis.